Comparison of Upper Limb Functional Outcomes in Stroke patients receiving Motor Relearning Programme (MRP) Vs. Proprioceptive Neuromuscular Facilitation (PNF)

BACK GROUND: The patients affected by stroke have been found to experience variety of difficulties. These disabilities produce physical, psychological and functional limitations in their day to day life. The major disruptive factor impending rehabilitation is the functional limitations of affected extremities. This study aims to compare two different concepts in clinical rehabilitation- First the specific reflex based neuro-facilitation technique of 1960’s PNF and Second motor control and motor learning concept based technique of 1980’s MRP on the upper extremity functions in stroke patients. AIM OF THE STUDY: The aim of the study was to compare the two techniques- the Poprioceptive Neuromuscular Facilitation (PNF) and Motor Relearning Program (MRP) on the upper limb functions in stroke patients. METHODOLOGY: A total of 30 patients suffering from stroke were selected and randomly allocated to two experimental groups (Group I and Group II ) till the number of 15 subjects were reached in each group. Assessments were done to measure level of upper extremity function using MAS (Motor Assessment Scale), functional independence using FIM (Functional Independence Measures) and Spasticity using Modified Ashworth scale. A structured- Occupational therapy protocols were tailored on PNF and MRP techniques and implemented. Group I is treated with MRP protocol and Group II is treated with PNF protocol. RESULT: After the implementation there is no significant improvement in MRP protocol than PNF protocol in improving upper limb functions. DISCUSSION: Occupational therapy activities are always graded and goal directed which depends primarily in the training of task parameters and functional adaptation. These occupational Therapy strategies have yielded improvements of in both PNF and MRP techniques. And there is no significant improvement in MRP than PNF. The result shows that no technique could show 100% improvement but they work on different aspects of disability. Therefore altogether these techniques will help in the improvement of the functional status of the stroke patients and there by reducing the disability related to stroke. CONCLUSION: The conclusion of the present study is that no one technique is found to be more effective over the other and the hypothesis that MRP is more effective in treatment of upper limb functions in stoke patients is found to be wrong. Both the treatment techniques were found to improve the upper limb functions in one or the other aspect and there fore it is more beneficial if the techniques will be used in adjunct to each other for rehabilitation so that the overall all improvement could be achieved

Understanding highly excited states via parametric variations

Highly excited vibrational states of an isolated molecule encode the vibrational energy flow pathways in the molecule. Recent studies have had spectacular success in understanding the nature of the excited states mainly due to the extensive studies of the classical phase space structures and their bifurcations. Such detailed classical-quantum correspondence studies are presently limited to two or quasi two dimensional systems. One of the main reasons for such a constraint has to do with the problem of visualization of relevant objects like surface of sections and Wigner or Husimi distributions associated with an eigenstate. This neccesiates various alternative techniques which are more algebraic than geometric in nature. In this work we introduce one such method based on parametric variation of the eigenvalues of a Hamiltonian. It is shown that the level velocities are correlated with the phase space nature of the corresponding eigenstates. A semiclassical expression for the level velocities of a single resonance Hamiltonian is derived which provides theoretical support for the correlation. We use the level velocities to dynamically assign the highly excited states of a model spectroscopic Hamiltonian in the mixed phase space regime. The effect of bifurcations on the level velocities is briefly discussed using a recently proposed spectroscopic Hamiltonian for the HCP molecule.Comment: 12 pages, 9 figures, submitted to J. Chem. Phy

A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge about Organ Donation among College Students at Selected Arts and Science College in Chennai

Organ donation is the process of giving an organ or a part of an organ for the purpose of transplantation into another person. Organ donation is legal by law because the Government of India has enacted "The Transplantation of Human Organs Act 1994" Act No.42, which has allowed organ donation and legalized brain death. Even 20 years after the Human Organ Transplantation Act majority of people are not aware of organ donation. There is a chronic shortage for organs and inadequate awareness about deceased organ donation. Approximately every 10 minutes; someone is added to the national waiting list for organ transplant. Lack of proper education to the attendants of a brain dead patient, lack of awareness among general public and college students about organ donation, organ donor cards, process of organ donation, add to the superstitions and misconceptions associated with organ donation in our country and make organ donation a tedious task. It is the lack of awareness only which keeps people away from the concept of organ donation. TITLE: “A study to assess the effectiveness of structured teaching programme on knowledge about organ donation among college students at selected arts and science college in Chennai’’. OBJECTIVES: 1. To assess the pre-test knowledge level regarding organ donation among arts and science college students in experimental group and control group. 2. To evaluate the effectiveness of structured teaching programme on organ donation among arts and science college students in experimental group. 3. To compare the post test level of knowledge score in experimental and control group. 4. To find association between the post- test knowledge on college students regarding organ donation and selected demographic variables among experimental group. MATERIALS AND METHODS: The study was carried out using a quantitative, true experimental design. 50 Arts and Science College students were selected from Gurunanak Arts and Science College students as experimental group and 50 Patrician arts and science college students were selected for control group. Samples were selected using a multi stage sampling with simple randomization. Pre existing knowledge was assessed for college students in both groups using a structured questionnaire prepared by the investigator and validated by the nursing experts. Structured teaching programme on organ donation was given to the participants in experimental group using PPT. Control group was not provided with any intervention. Post test was conducted in both the group after a week of intervention. Control group was provided with the same education using the booklets after the conduction of post test. RESULTS: The results shows that in experiment group, on an average, in post test after having structured teaching programme, the mean difference of knowledge gain score is experimental group students are having 15.64 knowledge score and control group students are having 7.24 knowledge score, so the difference is 8.40, this difference is large and it is significant. It was tested using Student independent t -test. The difference shows the effectiveness of structured teaching programme. There is a significant association between the knowledge gain score and the type of family, mother’s education, mother’s occupation, place living of status of the participants. CONCLUSION: The study results showed that there is an effectiveness of structured teaching programme on organ donation. Effective modules on organ donation can help to educate and create awareness to organ donation among arts and science college students and it can be applied in all settings. The study was appropriate, effective, feasible and cost effectiveness

Voicing Cohesion in the midst of COVID

Journal #30 from Media Rise's Quarantined Across Borders Collection by Charulatha Mani. From India. Quarantined in Queensland, Australia.Media Rise Publications. Quarantined Across Borders Collection. Edited by Dr. Srividya "Srivi" Ramasubramanian.I had to lose myself in the thick of the COVID to even begin to fathom the true value of the human voice

Prospective Randomized Comparison of Proseal LMA with Endotracheal Tube for Airway Management in Pediatric Patients

INTRODUCTION: Dr. Archie Brain developed a new way of linking artificial and anatomical airway, between 1981 and 1987.This new concept called Laryngeal Mask Airway combined the advantages of a non invasive facemask and the more invasive tracheal tube. Originally LMA was recommended as a better alternative to the face mask. But ever since its development the LMA has challenged the assumption that tracheal intubation is the only acceptable way to maintain a clear airway and provide positive pressure ventilation. Though LMA provided all the above advantages, the risk of gastric distension, pulmonary aspiration of gastric contents and fear of inadequate ventilation acted as a deterrent to the widespread use of LMA. To overcome the above complications, Dr. Archie Brain designed the Proseal Laryngeal Mask Airway (PLMA) in 2001, with modifications designed to enable separation of gastro intestinal and respiratory tract, improve airway seal, enable positive pressure ventilation and diagnose mask displacement. A Drain tube (DT) enables diagnosis of mask misplacement, reduces risk of gastric insufflation, regurgitation and aspiration of gastric contents. Prior to the advent of Proseal LMA, the endotracheal tube was the standard way of securing airway in children. Proseal LMA is the new airway device that forms a more effective glottic seal and it facilitates passage of a drain tube. It probably provides protection against regurgitation and prevents gastric insufflation when correctly placed. With this background this study was conceptualized to compare endotracheal tube and Proseal LMA for airway management in pediatric patients requiring elective surgery under general anaesthesia. Prior to the advent of Proseal LMA, the endotracheal tube was the standard way of securing airway in children. Proseal LMA is the new airway device that forms a more effective glottic seal and it facilitates passage of a drain tube. It probably provides protection against regurgitation and prevents gastric insufflation when correctly placed. With this background this study was conceptualized to compare endotracheal tube and Proseal LMA for airway management in pediatric patients requiring elective surgery under general anaesthesia. AIM OF THE STUDY: To evaluate the advantages and disadvantages of PROSEAL LMA over Endotracheal tube (ETT) for general anaesthesia in pediatric patients in the following parameters. 1. Ease of insertion of airway device. 2. No of attempts for insertion of airway device. 3. Time taken for insertion of airway device. 4. Ease of insertion of orogastric tube. 5. No. Of attempts for insertion of orogastric tube. 6. Hemodynamic responses. 7. Blood staining of devices. 8. Incidence of complications. MATERIALS AND METHODS: Study Design: Randomized prospective single center trial. Study Population: 60 children. Inclusion Criteria: 1. Elective pediatric patients requiring general anaesthesia. 2. Males and females. 3. ASA physical status 1 and 2. 4. Age 2- 6 yrs old. 5. Weighing 10 – 20 kgs. 6. Whose parents have given valid informed consent. Exclusion Criteria: 1. Children posted for emergency surgery. 2. Children with difficult airway. 3. Lack of written informed consent. 4. Children with cardio respiratory disease, URI, hiatus hernia , full stomach, history of convulsions. MATERIALS: Pediatric Proseal LMA size 2 1. Drugs: Inj.Atropine, Inj. Fentanyl, Inj. Propofol Inj. Atracurium, Emergency drugs, normal saline. 2. Macintosh laryngoscope with blade 1 and 2. 3. Endotracheal tubes of 3.5 mm ID to 5.0mm ID. 4. Monitors: ECG, NIBP, SPO2, ETCO2, precordial stethoscope. METHODOLOGY: 1. Pre – medication : Inj. Atropine 20 micg/kg , Inj. Fentanyl 2 micg/ kg, Inj. Ondansetron 0.1 mg /kg. 2. Preoxygenation with 100 % o2 for five minutes. 3. Induction: Inj. Propofol 2 mg / kg + Inj. Atracurium 0.5 mg / kg. 4. Placement of endotracheal tube or Proseal LMA. 5. Anaesthesia maintained with N2O / O2 1:1 with Sevoflurane. 6. Inj. atracurium one – third of the initial dose repeated if necessary. 7. HR, BP, SPO2 noted immediately, first, third and fifth minute after Insertion. 8. End of surgery : Reversal with Inj. Neostigmine 0.05 mg/kg + Inj Atropine 20 micg/ kg. 9. Perioperative respiratory complications noted on extubation. SUMMARY: The endotracheal tube has long been used as an effective airway in pediatric patients requiring general anesthesia. The disadvantages of using the endotracheal tube are hemodynamic responses following intubation, post extubation coughing and hoarseness. These can be overcome by using the Proseal LMA which has a drain tube to drain away stomach contents and can provide a safe and effective alternative to endotracheal tube in terms of ventilatory efficacy and maintenance of oxygen saturation. We conducted a study to compare the Proseal LMA and endotracheal tube in 60 pediatric patients. Anaesthesia induction and maintenance was similar in both the groups. They were compared for differences in effective airway time, hemodynamic responses following the use of the airway device and post extubation complications. The results of the study are as follows: 1. The Proseal LMA takes a significantly shorter time to insert than the endotracheal tube due to insertion technique which does not involve a direct laryngoscopy. 2. The changes in hemodynamic responses following insertion were higher in the endotracheal group. 3. The 8 Fr gastric tube can be easily passed through the Proseal LMA than the 10 Fr size which is recommended by the manufacturer. 4. The incidence of coughing and post operative sore throat is higher with the use of endotracheal tube .These complications occurred less frequently in the Proseal LMA group. CONCLUSION: PROSEAL LMA is a safe and suitable airway device in pediatric children as judged by stable hemodynamics, good oxygenation, adequate ventilation and lesser incidence of postoperative complications. Hence we can conclude that PLMA can be used as a safe and effective airway device to endotracheal intubation in children undergoing general anaesthesia

Chemical reaction rates using the semiclassical Van-Vleck initialvalue representation

A semiclassical IVR formulation using the Van-Vleck propagator has been used to calculate the flux correlation function and thereby reaction rate constants. This Van-Vleck formulation of the flux-flux correlation function is computationally as simple as the classical Wigner model. However unlike the latter, it has the ability to capture quantum interference/coherence effects. Classical trajectories are evolved starting from the dividing surface that separates reactants and products, and are evolved negatively in time. This formulation has been tested on model problems ranging from the Eckart barrier, double well to the collinear H + H{sub 2}

In vivo efficiency of Bacillus sp. isolated from biofloc system on growth, haematological, immunological and antioxidant status of genetically improved farmed tilapia (GIFT)

In aquaculture, Biofloc technology is emerging as one of the successful sustainable technologies to increase production. It is known to possess several immunostimulatory compounds exhibiting possible probiotic effect in culture. Here, we explored the in vivo efficiency of Bacillus infantis (T1), B. subtilis (T2), Exiguobacterium profundum (T3) and B. megaterium (T4) isolated from biofloc systems for improving the growth and immune performance of genetically improved farmed tilapia (GIFT). Animals (10+0.08 g) were stocked at a density of 100 per m-3 in 500 L FRP tanks for 42 days in triplicate. All the four probiotics (OD =1) were mixed with basal diet in treatments and feed without probiotic maintained as control. A significant difference (P <0.05) in weight gain, specific growth rate and FCR were observed between treatments and control with 100% survival. Serum albumin, globulin, protein, total blood count, glucose, myeloperoxidase activity and SOD were significantly different (P <0.05) between treatments and control. T4 and T2 showed better immunological and anti-oxidant ability when compared to other strains. Results from principal component analysis demonstrated that B. megaterium and B. subtilis can be the promising probiotic bacteria isolated from biofloc systems exhibiting multiple benefits with improved growth and health of the culture animals

In vivo efficiency of Bacillus sp. isolated from biofloc system on growth, haematological, immunological and antioxidant status of genetically improved farmed tilapia (GIFT)

714-721In aquaculture, Biofloc technology is emerging as one of the successful sustainable technologies to increase production. It is known to possess several immunostimulatory compounds exhibiting possible probiotic effect in culture. Here, we explored the in vivo efficiency of Bacillus infantis (T1), B. subtilis (T2), Exiguobacterium profundum (T3) and B. megaterium (T4) isolated from biofloc systems for improving the growth and immune performance of genetically improved farmed tilapia (GIFT). Animals (10+0.08 g) were stocked at a density of 100 per m-3 in 500 L FRP tanks for 42 days in triplicate. All the four probiotics (OD =1) were mixed with basal diet in treatments and feed without probiotic maintained as control. A significant difference (P 0.05) in weight gain, specific growth rate and FCR were observed between treatments and control with 100% survival. Serum albumin, globulin, protein, total blood count, glucose, myeloperoxidase activity and SOD were significantly different (P B. megaterium and B. subtilis can be the promising probiotic bacteria isolated from biofloc systems exhibiting multiple benefits with improved growth and health of the culture animals

Triple-helical collagen hydrogels via covalent aromatic functionalization with 1,3 phenylenediacetic acid

Chemical crosslinking of collagen is a general strategy to reproduce macroscale tissue properties in physiological environment. However, simultaneous control of protein conformation, material properties and biofunctionality is highly challenging with current synthetic strategies. Consequently, the potentially-diverse clinical applications of collagen-based biomaterials cannot be fully realised. In order to establish defined biomacromolecular systems for mineralised tissue applications, type I collagen was functionalised with 1,3-phenylenediacetic acid (Ph) and investigated at the molecular, macroscopic and functional levels. Preserved triple helix conformation was observed in obtained covalent networks via ATR-FTIR (AIII/A1450 [similar] 1) and WAXS, while network crosslinking degree (C: 87–99 mol%) could be adjusted based on specific reaction conditions. Decreased swelling ratio (SR: 823–1285 wt%) and increased thermo-mechanical (Td: 80–88 °C; E: 28–35 kPa; σmax: 6–8 kPa; εb: 53–58%) properties were observed compared to state-of-the-art carbodiimide (EDC)-crosslinked collagen controls, likely related to the intermolecular covalent incorporation of the aromatic segment. Ph-crosslinked hydrogels displayed nearly intact material integrity and only a slight mass decrease (MR: 5–11 wt%) following 1 week incubation in either PBS or simulated body fluid (SBF), in contrast to EDC-crosslinked collagen (MR: 33–58 wt%). Furthermore, FTIR, SEM and EDS revealed deposition of a calcium–phosphate phase on SBF-retrieved samples, whereby an increased calcium phosphate ratio (Ca/P: 0.84–1.41) was observed in hydrogels with higher Ph content. 72 hours material extracts were well tolerated by L929 mouse fibroblasts, whereby cell confluence and metabolic activity (MTS assay) were comparable to those of cells cultured in cell culture medium (positive control). In light of their controlled structure–function properties, these biocompatible collagen hydrogels represent attractive material systems for potential mineralised tissue applications